A Memory Supplement to Forget

You may have seen the TV and online ads for Prevagen, a best-selling dietary supplement that’s claimed to be “clinically shown” to improve memory and help prevent age-related cognitive decline. I hope you didn’t spend the $24 to $68 a month it costs—but if you did, you may be eligible for a refund at some future date. In January the Federal Trade Commission (FTC) and New York Attorney General Eric Schneiderman filed a well-argued complaint against the marketers of Prevagen for making unsubstantiated health claims, asking for a halt to such advertising as well as refunds for consumers. “The marketing for Prevagen is a clear-cut fraud, from the label on the bottle to the ads airing across the country,” according to Schneiderman.

Here are just a few of the problems with Prevagen:

• Published in an obscure journal, the clinical trial touted by the marketers as proving the efficacy of Prevagen actually found no overall benefit compared to a placebo for its primary endpoints involving memory and cognition. That should have been that. But the researchers, all employed by the maker of Prevagen, then did a series of subgroup analyses, a few of which found slight improvements in smaller groups of participants, mostly those who had little or no cognitive difficulty at baseline. Such secondary analyses are unreliable and—at the very least—represent cherry-picking the data for something positive to report. There were other methodological problems with the study as well.

• The primary ingredient in Prevagen is a synthetic version of apoaequorin, a protein originally derived from certain jellyfish. The Prevagen researchers hypothesize that, by regulating levels of intracellular calcium, “apoaequorin has the potential to improve the function of aging neurons and, therefore, to enhance memory and cognitive function.” This is scientifically implausible. Even if this hypothesis were true, as the FTC points out, the company’s own “safety studies show that apoaequorin is rapidly digested in the stomach and broken down into amino acids and small peptides like any other dietary protein.” And even if the orally consumed protein somehow got into the bloodstream, there’s no evidence that it can cross the human blood-brain barrier to affect neurons.

• The company boasts that the scientist who “discovered” apoaequorin and his colleagues won the Nobel prize in chemistry. That’s true, but that was for basic research on how jellyfish glow in the dark—it had nothing to do with human brain health. There’s even question about whether synthetic apoaequorin meets the FDA’s regulatory standards for a new ingredient in a dietary supplement.

Bottom line: Prevagen is a poster child for unproven memory supplements and the marketers who use faulty science or pseudoscience to target people worried about their memory. Whether they contain vitamins, minerals, herbs, or a laundry list of “miracle” ingredients, memory supplements are not supported by solid clinical evidence. Save your money.

Update: In September 2017 a federal judge dismissed the lawsuit filed by the FTC and New York Attorney General against the maker of Prevagen because, he said, it failed to prove that reliance on secondary analyses is misleading. The plaintiffs are likely to appeal the ruling.